ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment 2020 B
1. A client has been prescribed lithium for bipolar disorder. Which of the following should the nurse teach the client to monitor for signs of toxicity?
- A. Nausea and vomiting
- B. Increased urination
- C. Tremors
- D. Blurred vision
Correct answer: C
Rationale: The correct answer is C: Tremors. Lithium toxicity can present with symptoms such as tremors, nausea, and blurred vision. Tremors are a common early sign of lithium toxicity and should be monitored closely. While nausea and vomiting can also occur with lithium toxicity, tremors are more specific to lithium toxicity. Increased urination is not typically associated with lithium toxicity, and blurred vision is less common compared to tremors in this context.
2. A nurse is caring for a client who has been taking haloperidol for several years. Which of the following assessment findings should the nurse recognize as a long-term side effect of this medication?
- A. Lip-smacking
- B. Agranulocytosis
- C. Clang association
- D. Alopecia
Correct answer: A
Rationale: Lip-smacking is a symptom of tardive dyskinesia, a long-term side effect of antipsychotic medications like haloperidol, characterized by involuntary movements of the face and jaw. Agranulocytosis (Choice B) is a rare but serious side effect of some medications, characterized by a dangerously low white blood cell count. Clang association (Choice C) is a thought disorder characterized by the association of words based on sound rather than meaning. Alopecia (Choice D) refers to hair loss, which is not a known long-term side effect of haloperidol.
3. A client is being taught about the use of levothyroxine. Which of the following should be included?
- A. It should be taken on an empty stomach
- B. Monitor for signs of hyperthyroidism
- C. It is a pain reliever
- D. It should be taken in the morning
Correct answer: B
Rationale: When educating a client about levothyroxine, it is important to emphasize the need to monitor for signs of hyperthyroidism. Levothyroxine should be taken on an empty stomach, preferably in the morning, to maximize its absorption. Choice A is incorrect as it should not be taken with food. Choice C is incorrect as levothyroxine is not a pain reliever. Choice D is incorrect as levothyroxine is usually taken in the morning.
4. A nurse on a rehab unit is creating a plan of care for a newly admitted patient who has difficulty swallowing following a stroke. Which interprofessional team members should the nurse anticipate consulting?
- A. Physical therapist
- B. Speech-language pathologist
- C. Social worker
- D. Respiratory therapist
Correct answer: B
Rationale: The correct answer is B: Speech-language pathologist. A speech-language pathologist specializes in assessing and treating swallowing disorders, making them the most appropriate consultant for a patient with difficulty swallowing following a stroke. While other interprofessional team members such as a physical therapist (choice A), social worker (choice C), and respiratory therapist (choice D) may play important roles in the patient's care, the primary focus for swallowing difficulties would be the speech-language pathologist.
5. A nurse is teaching about foot care to a client who has diabetes mellitus (DM). What statement indicates understanding?
- A. I should wear my slippers whenever I am out of bed
- B. I can walk barefoot at home
- C. I should apply lotion between my toes
- D. I can soak my feet in warm water
Correct answer: A
Rationale: The correct answer is A. Wearing slippers or shoes when out of bed is crucial for clients with diabetes as it protects the feet from injury. Walking barefoot, as mentioned in option B, can increase the risk of cuts, sores, and infections in diabetic patients. Applying lotion between the toes, as stated in option C, can lead to maceration and increase the risk of fungal infections. Similarly, soaking feet in warm water, as mentioned in option D, can cause skin breakdown and should be avoided by diabetic patients.
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